When doctors quit, pay is not the main reason

A survey of 251 physician groups indicates that compensation is not the number one reason when physicians leave a group voluntarily. That primary spot is held by practice issues, said 31 percent of the respondents. In small groups (3 to 50 physicians), however, compensation was the number one reason for separation (45 percent). The top five reasons given by physicians who left a medical group were: practice issues, compensation, location, spouse’s career, and pressure of clinical practice, according to the 2004 Cejka Search and AMGA Physician Retention Survey.

"When you look at why physicians leave, compensation is not that critical," says Carol Westfall, president of Cejka Search. "What was surprising was the finding among smaller groups. Historically, physicians believe you make more money in smaller groups — the argument is that the overhead is lower and the physician will be able to see more of a return. Even if the compensation were higher in smaller groups than larger groups, maybe the departing physicians were still disappointed in the results, or maybe the volume wasn’t there to generate the income they expected."

Further, family practice physicians and internists ranked highest in turnover, leaving groups at a rate of 19 percent of total departures. This is not necessarily surprising, as primary care often makes up a larger percentage of a medical group’s total physicians. Specialists with the highest turnover, behind the family physicians and internists, were orthopedic surgeons (7 percent), pediatricians (7 percent), gastroenterologists (6 percent), surgeons (6 percent), and OB/GYNs (5 percent).